Individual provider Active NPI

Nivedita Nijhawan, D.D.S

  • General Practice Dentistry
  • Fresno, CA
National Provider Identifier
1760816680
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62886 Issued in CA
Practice address
1382 E Alluvial Ave Ste 104
Fresno, CA 93720-2699
Phone
(559) 224-1303
Fax
(559) 225-3236
NPI assigned
Aug 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 62886 CA
General Practice Dentistry 1223G0001X 62886 CA Primary

Addresses

Primary practice location

1382 E Alluvial Ave Ste 104
Fresno, CA 93720-2699

Mailing address

1382 E Alluvial Ave Ste 104
Fresno, CA 93720-2699
Phone (559) 224-1303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140131001909 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6709015266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nivedita Nijhawan D.D.S., Inc CurrentSince Mar 10, 2017 Accepting new patients

Locations

1382 E Alluvial Ave
Ste 104
Fresno, CA 93720
Phone (559) 224-1303

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1760816680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1382 E ALLUVIAL AVE STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202699",
            "telephone_number": "559-224-1303",
            "fax_number": "559-225-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1382 E ALLUVIAL AVE STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202699",
            "telephone_number": "559-224-1303",
            "fax_number": "559-225-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIJHAWAN",
        "first_name": "NIVEDITA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62886",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.